One of the most common operations in orthopaedics and sports medicine is surgery for a torn meniscus. I get a lot of questions about what this surgery involves, how long it takes to recover, and when it should be done.
What is the meniscus and why did it tear?
The meniscus is a cartilage disc between the bones in your knee. There are two of them, one on the medial or inner side, and one on the outside. They act like shock absorbers between the bones in the knee that are also covered in cartilage. There are many different causes of meniscus tears. Athletes will often injure them in a cutting or twisting maneuver. It can also come from a simple stumble or squatting too low. Some meniscus tears come with maturity as part of the wear and tear process of the knee. When the meniscus tear is large enough, the torn edges will catch and cause pain in the knee. There may be swelling or locking as well. Patients will often be able to localize the pain to the side or back of the joint line of the knee. However, some tears that go along with arthritis of the knee are more difficult to localize and have a vague ache deep inside the knee.
What does meniscus surgery involve?
Most meniscus surgery is done arthroscopically as an outpatient, so patients typically go home the same day. A small camera about the size of a writing pen is inserted into the knee and other small tools can be used to repair or trim the meniscus. When possible, a repair of the torn meniscus can be performed. However, some tears are not repairable because of their orientation or delayed treatment. These tears will be trimmed back so the tear does not spread any further or cause damage to the rest of the cartilage on the ends of the bones of the knee. While this procedure removes some of the meniscus or shock absorber in the knee, the damage that could be done with activities on the torn meniscus can be worse.
When should meniscus surgery be performed?
An MRI or a physical exam indicating a meniscus tear is the first line of treatment. After a meniscus tear is found, it is important for your surgeon to decide if this is the cause of your trouble. Several studies show that older patients tear their meniscus as part of the wear and tear process of arthritis. These patients may have vague achiness in their knee that may not be related to meniscus tears. While surgery for these meniscus tears can be satisfying and possibly slow down the progression of arthritis, the patients need to understand the ache of arthritis may occasionally bother them.
Younger, more active patients can often feel the meniscus catching or moving in their knee and should get good results from either repair or partially resecting their injured meniscus. I always believe conservative, non-operative treatments should be considered unless the symptoms are keeping individuals from day to day activities that they enjoy.
How long is recovery?
While the procedure takes a short time to perform and most of the pain is relieved quickly, it can take several weeks for the knee to feel strong again. It will take a few days for swelling to subside. Also, the muscles in the leg may feel weak after surgery for a few days. Physical therapy exercises can help rehabilitate the leg quicker. Most individuals return to their normal lifestyle quickly, but it may take a couple of months before for complete healing and feeling like they did before injury.
Dewey Jones, IV, MD is an orthopaedic surgeon who practices with Southlake Orthopaedics Sports Medicine and Spine Surgery.
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